Category Archives: PTSD

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(Kitty is working on overcoming agoraphobia and writes from time to time about her process. Here’s some sound advice about setbacks.)

How regress can be progress

I had some setbacks recently, lots of very high anxiety days and a lot of panic attacks. It’s easy to get disheartened by stuff like this. It’s easy to wonder why you should bother. But you must not think that way. Setbacks and relapses happen to everyone recovering from something. They are always temporary and much easier to bounce back from than the original problem. If you’re climbing a tree to get away from a bear and you fall back one branch, do you jump down from the tree and let the bear eat you? No. You keep climbing. It was just one branch and you’re still farther from the bear than you were when you started. So if you fall in your recovery, keep climbing.

In my experience, when you have a relapse it’s best not to dwell on thoughts like, “But I was doing so well.” You’re still doing well. It’s not your fault the anxiety is stronger this week. You didn’t do anything wrong in your exposure. Keep doing your exposure during a relapse too. It’s harder but it will prevent the agoraphobia from becoming more malignant again. The best thing to do is ride it out. It will end – probably in a week or two. In my experience, relapses never last longer than that. Just keep reminding yourself that it’s temporary. Maybe do twice the meditation and/or mindfulness exercises that you usually do.

When your anxiety gets unusually high, it might not be best to jump to the benzo bottle as quickly as you normally would during a bad streak, because you would end up using it too often. One of the best ways to get rid of anxiety is to forget you’re having it. There are several ways that I go about doing this. As I mentioned in my intro post, sometimes I call a family member or a friend who I have really good conversations with and they will get me so involved in talking about another subject that I forget I’m anxious and it goes away.

Then there’s mindless television. I never pick a show I’m gonna connect with or have emotions about for this. I pick things like Bigfoot documentaries or World’s Wildest Police Chases. Reading is a good one, because that engages all of your brain. There’s no part left over to be anxious with. I’m partial to Sherlock Holmes stories.

The important thing to remember is that setbacks will happen, but they never have to mean a return to square one.

Chronic anxiety and panic attacks can take the stuffin’ out of you and turn you into a meek and cowering victim. I know from many years’ experience with panic disorder that the condition of being constantly on alert drains one physically and psychologically. My long struggle with anxiety turned me surprisingly passive.

Now, if something is holding back my dreams and goals I get properly pissed off and take action. When I was subdued by mental illness, however, I felt oddly powerless; I just sort of let the thing take me over. I wanted to be assertive, but expressing any kind of strong feeling was terrifying somehow. I felt so close to the breaking point so much of the time that I feared any strong display of emotion might tip me over.

Panic disorder and agoraphobia had me by the throat and I was afraid for far too long of fighting back. I couldn’t be assertive in the face of possibly increased anxiety. As I started seeing therapists, though, and sharing fear experiences in peer group settings and doing research, I began to understand my power and how to use it to become free.

The psychiatrist who said to me, “You know what your problem is?… you don’t love yourself” started the ball rolling – by making me understand I needed to start taking very good care of the most important and lovable person in the world – me. I wish I could say my quest to become assertive and actively pursue a solution to my anxiety problem was a continuous journey, but addiction to alcohol and tranquilizers was still in my way.

Once I stopped trying to cure anxiety with alcohol and pills I became astonishingly less anxious. At that point my understanding of the importance of me and the will to make my well being a priority came into play. I was relentless thereafter in working selfishly for once on solving my problems. I soon realized the value of being assertive, as my confidence increased to the point where the thought of traveling frightened me less and less.

All that led to the momentous day when I burst through my agoraphobia prison wall and have been merrily traveling about since – more than 20 years ago. It became possible because I somehow found the will to make myself into a full human being again – one who could get angry and stand up for himself and get things done. So my advice to you is right here when you are ready for it. The sooner you start acting “selfishly” the sooner you’ll recover from panic disorder.

I’m providing a link to an excellent read on the importance of “selfishness.:

Would you take a med for your anxiety if the doctor told you this about it?:

It won’t fix your problem

Your body will be addicted to it within a few months as it loses its effectiveness, and…

When you are addicted, you will experience anxiety as a side effect of withdrawal (daily, when it’s getting close to dose time).

I’m talking about the benzodiazepine family – Xanax, Valium Klonopin, Atavin, et al – and I’m revisiting the tranquilizer problem because use of the addictive medication is growing globally. I browse various online peer support groups for anxiety, and it seems most people writing in are taking some form of medication long term, perhaps unaware they are making their problems worse.

Statistics from the American Psychiatric Institute say doctors write 50 million prescriptions a year for benzos, and that between 11-15 percent of Americans have a bottle of benzos in the house. The API report pointed out that the med is best used for short term relief of extreme anxiety. If intense fear is keeping you from working on recovery, I advise talking to your doctor about your recovery work and request a short run with a benzo –like 3 weeks max. Klonopin has the longest life cycle, meaning fewer doses per day.

I can talk about this because I was addicted to Xanax for several years. What I was taking to treat my panic attacks and agoraphobia actually delayed my recovery by years. I guarantee you cannot overcome your panic disorder and agoraphobia while you are addicted to benzos because they create anxiety. I can talk about this because I worked as a mental health social worker for 17 years and sat in with psychiatrists as they prescribed for clients of mine with a variety of mental illnesses. I’ve heard many a lecture about the dangers of benzodiazepines and have read widely on the subject.

Please listen to me. If you are not now engaged in regular work toward recovering from panic disorder, begin doing so at once and then schedule an appointment with your prescriber to begin a slow tapering off process. I went off benzos twice during my prolonged use. The first time was spread over a few months, and I felt somewhat anxious most of that time. After I was off, the anxiety totally disappeared. The second time was hard; it was in a medical addiction treatment center, and I was coming off both alcohol and Xanax. I had Valium for a couple of days, but then cold turkey.

I shook so badly for several days that feeding myself became problematic. Finally one of my fellow patients brought back from the kitchen one of those 2-foot long metal stirring spoons so I could transport food to my mouth. This could be you someday, is why I’m mentioning it.

Panic disorder can be totally overcome by anyone willing to put in the work required to re-wire the way you think, respond and create. I recently read the piece I’m providing a link for below; it’s the best story on benzos I’ve seen.

I repeatedly stress to sufferers of panic disorder that learning to meditate and to perform your daily activities with full, mindful focus is what will lead you out of the morass you’re in. I can’t think of a better model for explaining the importance of living in the present than Eckhart Tolle.

Tolle (tolay) is the German Canadian author of “The Power of Now” who reports he spent much of his early life in deep depressive despair. He says he was in a very dark time when, at age 29, he had a transformation – he realized he could live his life in bliss just by living every moment completely immersed in the time called now.

I have a chapter in my book on engaging in mindful activities as well as meditation in order to steer your mind clear of the anxiety-provoking future and the depression-invoking past. Focusing every day on your recovery program is what I give you as a way to work always in the present moment. I had to learn how to escape the all-consuming presence of anxiety for at least brief periods of time so I could know what I was searching for. I know that getting into a clear state of mind was what allowed me to be creative – to invent ways to heal myself.

The reason I think Tolle is so brilliant at helping folks learn this vital skill, or habit, or way of being, is that he, when you see and hear him, is the perfect embodiment of peace and joy. His sweet face and compassionate manner are the result of being always here instead of back there or on up there. I have watched hours of youtube vids on meditation and living in the present, and somehow get the most help from Tolle.

I’m giving you a link to a vid that will help you see what he’s about, and you will see many more presentations from him on a variety of subjects. Do what he tells you and what I tell you and you will free yourself from your own prison.

I get asked from time to time about the difference between “panic disorder” and “post traumatic stress disorder.” I know about panic disorder from personal experience and PTSD from association as a mental health social worker. The definition of the word “trauma” is what separates the two anxiety disorders.

I developed PD as a result of having had one too many panic attacks. My first attack was at age 10, and I had episodes of panic attacks at various times during my youth. The one I had while traveling at age 19 was the topper – the one that turned me into someone so frightened of having another terrifying panic attack that I avoided travel for the next 30 years. What I experienced was a trauma. My traumatic event was a panic attack over essentially nothing. There was nothing real to frighten me, but the experience of the attack traumatized me.

Someone with clinical PTSD truly experienced something horrific. The person saw, heard, felt, smelled something that triggered their “fight or flight” system to become constantly alert to any new dangers. I had people on my caseload who were struggling with the symptoms of PTSD, the result of everything from wars to accidents to assault and abuse.

The “trauma” of having a panic attack is obviously vastly different from the “trauma” of a land mine or a vicious beating or a horrific accident, but the effects can be similar. The hyper vigilance of a person diagnosed with PTSD is, from a brain mechanics point of view, much like the state of anxiety one feels fearing the effects of yet another panic attack. In both cases, severe anxiety can force the person into avoidance as a means of survival. Both disorders can create “agoraphobia.”

As horribly frightened as I was by panic attacks many times over the years, my suffering cannot compare to the suffering of someone who hears and sees the terrifying cause of their mental illness in dreams and flashbacks. That sort of agony is beyond my comprehension.

One similarity of PD and PTSD is that in many cases the actual “threat” is not present – the fear is of a reappearance or a recurrence. In both cases, treatment requires a re-programming of the amygdala-controlled alarm system. My program in Un-Agoraphobic can lead anyone to overcoming chronic panic attacks through specific activities and processes. Intensive psychotherapy may be required to help a PTSD victim cope with and learn to live with the specific memories.

Here’s a link to an excellent (and readable) scholarly article on the role of the amygdala in anxiety. The Biology of Mood and Anxiety Disorders is a good place to do research on your disorder.

I have more than once pretended to be happy about something or another in order to please or at least placate someone else, but it turns out I could also fool myself by faking it.

Brain scientists have shown that focusing on and repeating any thought, action or behavior stimulates the brain into creating new neural pathways in order to facilitate that process. It makes sense to me; it’s sort of like you start lifting weights and after awhile it gets easier because your muscles get bigger and more efficient.

If you suffer from panic disorder you have evidence close at hand proving the brain will pay attention to whatever you want to focus on at that particular time. You have subconsciously and consciously informed your central nervous system that you are in some sort of danger, so the system gears up to be ready whenever the “danger” occurs. That’s why you’re nervous. You are tense and tight and hyper-vigilant because your amygdala thinks something bad is going to happen without warning.

Your high level of anxiety of course makes it much more likely you’ll be startled or stimulated which will trigger a flood of adrenaline that creates the extreme feeling of terror we call a “panic attack.” The bad thing happening is happening because you programmed yourself to be on the look out for fear. It’s not something you were necessarily doing on purpose, but because the feeling of being in danger (from a panic attack) creates new thought pathways, pretty soon you’re stuck with being a nervous wreck.

Luckily, your brain will do pretty much anything you want it to, even feeling calm and at ease. You can totally reverse your current situation though the response may be slow in coming. There’s lots to undo and redo, but you can do it. I set up a daily work program in my book, Un-Agoraphobic to accomplish that very thing – to set the brain in motion with positive thoughts and and activities. Creating new neural pathways that relate to safety and comfort and happiness is what will help you recover from panic disorder and agoraphobia. To start it off, all you have to do is smile, as you’ll learn in the following article.

Lettuce now compare agoraphobia to a garden.I officially began garden season today by planting some seeds in flats and plastic containers, and for each minuscule form of life I planted in the soil, at least one seed of thought got planted in my brain. Writers who garden are constantly pruning their greenery to harvest similes and metaphors that relate the horticultural arts to one’s life as well as the lives of others.

Gardening is particularly ripe with meaning for those afflicted with panic disorder and agoraphobia. Here, I’ll make up a few metaphors and similes which I hope will help you sprout some of your own.

You have taken root in an area that is restricting your growth.

You have seeds you’d like to sow far from where you are.

You are a fragile seedling that needs particular protection from the elements.

You are a seed, full of potential, but don’t have access to soil where you can truly sprout.

Whenever you try to spread, giant nasty weeds confront you, driving you back to your spot.

When you finally get to bloom, your flower will be the most beautiful display ever seen.

I could go on and on – after all, I’m a writer – but now it’s your turn to think of ways your situation can be compared to gardening. I wrote a blog earlier on how important the season of Spring has been to me through my life. When I was a prisoner of agoraphobia, Spring represented renewal, new growth, new possibilities, and hope. My hostile world, particularly the coldest months, seemed somehow softer and safer when Spring arrived in my home state of Montana.

Because this season is so important to me, I decided to increase my share of it by moving to central Oregon where Spring begins about two months earlier than in Montana. In some ways, the Willamette Valley is eternal Spring with a touch of 2 or 3 others.

So I planted some seeds today and thought about their future. They didn’t look like much as I gazed upon them nestled in my garden stained palm. Each tiny seed can reach its potential and become a most magnificent living thing, be it broccoli, carrot or zinnia, only by undergoing a dramatic change. I will be the agent for change – by pushing each seed beneath the surface of dirt and then faithfully watering and fertilizing and nurturing, giving each the best possible chance to become the best it can be.

Now let’s make you the seed and the recovery program in Un-Agoraphobic all the soil, nutrient, water and sunshine you need to become the being you hoped you would. You must now carry out each day devoted to the care and nurturing of this precious new you. The growth you are undertaking will lead to a dramatic change – complete freedom forever. Have fun. Only a negligent gardener could ruin your chances.

I know of a way to help you make some significant progress in your recovery from chronic panic attacks. I want you to start making a daily deposit in your memory bank of a calm, focused, period of time when you are so fully engaged in an activity or project that anxiety disappears or is forgotten for the moment. When you establish your daily routine of “mindful” activity, I want you to start observing and taking note of what is going on with you during these periods of time so you can get accustomed to the feeling and make it easier to slip back into that space.

Once your memory-making center starts getting a regular dose of calm feelings, you’ll find that new neural pathways are being formed, making it easier and easier to “feel the feeling” whenever you need to. I’ll give you a couple of examples of times when your focus takes away absolutely everything else. Think of looking up a number in a telephone book with that teensy type, or for something in a long list or for something you’ve lost around the house. Anytime you’re engaged in a search for something you need, you mostly tune out everything else. I’m sure you can think of many things you do for a tiny period of time when nothing else is going on in your psyche.

When you get to that zone for an extended period, take note of how things seem around you – and how you fit in. Take note of everything – your breathing rate, your posture, the feel of your hands, arms and shoulders. Do you feel loose and comfortable, or at least more so than usual? What does your mind feel like when it’s not racing away with anxious notions? You don’t have to write these sensations down, just feel them fully and remember them.

Now I want you to discover something you can do every day for an hour or more that will require all your attention while you’re doing it. My book, Un-Agoraphobic, contains a section on learning a new skill to provide a daily session of meditative activity. If you’re already engaged in learning a new skill, you know what’s up. If you’re not, and you don’t have something in your life that takes the kind of focus I’m describing, I want you to start drawing.

Learning to draw saved me during a particularly stressful time in my life. I started doing it as pure diversion, but soon discovered the process of learning to draw was actually healing me. On my very first outing of serious drawing, two hours disappeared…. just like that. I was gone for two peaceful, serene hours during a period in my life of fairly high anxiety. I became pretty good at drawing because it felt so good I did it every day. Drawing is good therapy. It teaches you to see things in an entirely new and engaging way.

Starting tomorrow, set up a little still life of stuff around you – like your shoe and a cup and an apple or a small box or book. Get some copy paper and any old pencil and start at one point in the arrangement of things before you and just let your eye stay right on the line as your pencil and hand and eye work together to re-create exactly what your eye is seeing onto that piece of paper. It doesn’t have to look good at all. That’s not the point. The point is fully engaging your attention on the line of that box as it goes up and then away from you at its topmost and then at a slight angle to your right and on and on. You’ll make straight and curvy and broken lines, but there’s always a line and it’s your job to follow it wherever it goes and tell your hand how to replicate what your eye and brain are doing. Keep the graphite on the paper and keep the line moving in a flowing way. Draw exactly what you see. The process is fascinating.

Tomorrow morning when anxiety starts on a roll, go to your memory bank for a withdrawal of centered feelings like you had yesterday when you were gone to a very specific time and place. You don’t even have to start doing something; all you have to do is recall the feeling you remember so well.

Good nutrition was about the last thing on my mind during times of high anxiety, obsessed as I was with fear over the threat of yet another panic attack. I didn’t eat at all well during panicky periods and many of those “periods” went on for months. I know now I could have decreased my anxiety and hastened my recovery by figuring out easy ways to get something wholesome in me.

“Eat (While) Nuts & Also Berries” is a chapter in my book that shows folks suffering high anxiety how to get the best nutrition possible under the circumstances. You may not be able to get to the store very often and even if you have food around, you are so tense and your body so tight that even swallowing becomes difficult. I was able to overcome that problem by making healthful smoothies – or shakes – in the blender. What you make will be 10 times better than those little canned nutrition beverages. Here are some tips for doing that for yourself:

– Buy protein powder and use enough each time to make it a “meal replacement.” Whey and soy proteins are good, but if you are lactose and soy intolerant as I am, choose from among several plant protein products. Pea powder provides the most protein of them all, according to what I’ve read, but there are other appealing plant based protein sources. I buy pea powder and one or another of the green ones and put in a scoop of each. Double up whatever you’re using.

–Use fresh fruit as often as you can and blend in whatever is available. I use a banana, 4 or 5 big strawberries and a handful of blueberries. I have a big strawberry patch and a few blueberry bushes, but I live in berry country so it’s easy for me to benefit from the essential micro-nutrients in the sweet little fruits. You can probably obtain some kinds of fresh fruit through the winter and buy bags of frozen strawberries and blueberries.

– Liquids include “milk” from many sources. If you are lactose intolerant, you have several options for something to pour on your daily granola or to put in smoothies. You can buy non-lactose dairy milk, or soy milk is good nutrition if you can tolerate it. I use “almond milk” because it seems to provide good food value. I’ve seen coconut milk, among others in the dairy cases. It’s best not to use fruit juices regularly for your liquid meal because they are high in fructose. Fruit itself is not, but fruit juices contain the worst kind of sugar (of sucrose, lactose and fructose). I see in the news these days high fructose corn syrup being blamed for obesity and diabetes. I believe it and won’t buy products containing it. Nearly all commercial jams contain HFCS to our detriment.

-Other ingredients can include wheat germ and any edible seeds. A decent blender will grind up sunflower seeds and squash seeds. I throw in a tablespoon of flaxseed meal.

Keep foods around that won’t spoil quickly and are easy to get at and nibble on. Cut up veggies and put them in a jar in the fridge; keep a head of lettuce or spinach in there as well, so you can just rip off a bit in passing. You don’t have to make salad to have salad. Other tips for eating during anxious times include hard boiled eggs, deli cheeses and meats and pancakes. Make sandwiches to keep you busy and freeze some. Trail mix with nuts and raisins and chocolate chips is something I could make and have around for emergencies.

Eating well will help make you well. Here’s a good read on that very subject:

When anxiety is having its way with you, leaving your domicile becomes a daily, dreaded chore. Because I struggled getting to work or school for many years as a victim of panic disorder, I want to help you take on the day so you’ll face only new opportunities instead of new threats.

I’m revisiting this because being able to travel to work or school is vital to your survival and there are so many people who struggle with this daily event – the journey into the unknown. This is for the folks who have to make a living or stay in school and suffer panicky feelings in order to do so.

My recovery program for agoraphobes includes a variety of activities and practices throughout the day designed to help make neural changes in your brain, and over time this work is what will set you free. In the meantime, as you battle anxiety throughout the day, the best advice I can give is to stay in the present moment. Paying close attention to what you are doing and where you are throughout the journey will enable you to step confidently and serenely into the day.

I advise taking along your journal or notebook and a camera as you begin a new way of leaving home and leaving the anxious you behind. Be mindful of everything around you and record it as a means of getting out of your head and into a connection with your environment. Peace comes from this if you do it right. As you’re walking feel the surface and make note of what your feet are touching. Describe it in detail. And on and on through your daily journey, take a new view of what you encounter.

Getting into and staying in that frame of mind can be admittedly difficult. But once you fully understand what it means to be in the moment you’ll be able to benefit from the values of meditative, mindful behavior. Here’s an excellent piece by psychologist Dr. John Amodeo on living in the present moment. I hope you’ll read it. I learned from it and I hope you will also. Here’s to healing through learning:

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Unagoraphobic.com – is the one web site and blog dedicated solely to recovery from panic disorder and agoraphobia and we want you to think of this as your home. This is a safe place where you can read and write comments as well as ask questions and get answers about agoraphobia. Millions of people around the world from all levels in society suffer from this condition. Now there’s a structured program designed to heal the whole you and free you from your prison. I created the agoraphobia Recovery Program based on my experiences as a long time sufferer (30 years), as a mental health social worker and as a writer. I look forward to hearing from you as you begin your journey.